Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2003;56:128-36 - Vol. 56 Num.02

Analysis of Differences in Flow-Mediated Dilation in Relation to the Treatment of Coronary Patients

Enrique Novo García a, Javier Balaguer a, Eulalia Jiménez a, Alberto García Lledó a, Manuela Caballero a, Manuel Chaparro a

a Sección de Cardiología. Hospital General Universitario de Guadalajara. Guadalajara. España.

Keywords

Endothelium. Risk factors. Prevention. Drugs.

Abstract

Introduction. Flow-mediated dilation (FMD) is thought to be related to the development of coronary disease. We were interested in knowing the degree of FMD in a large sample of coronary patients in relation to the therapy they were given in clinical practice. Patients and method. We studied 1,081 coronary patients (age 68 ± 12 years, 73% male) in which FMD was evaluated in the brachial artery. The patients were classified into 5 treatment groups (416 who receive 2 or more treatments were excluded): group A: 81 controls treated with aspirin, group B: 198 treated with ACE inhibitors, group C: 106 with calcium antagonists, group D: 145 with β-blockers, and group E: 135 with lipid lowering medication (93% statins). Results. ANOVA was used to analyze the differences between groups. With regard to the number of risk factors present in each group, the patients treated with ACE inhibitors (2.44 ± 0.79 vs 2.14 ± 0.89; p < 0.05) and statins (3.45 ± 0.70 vs 2.14 ± 0.89; p < 0.05) had more risk factors than GrA and higher levels of LDL-cholesterol (ACE inhibitors 145.0 ± 33.5 vs 128.5 ± 32.2 and statins 157.8 ± 45.3 vs 128.5 ± 32.2; p < 0.05). GrB had a higher glycemia than controls (123.4 ± 32.2 vs 114.7 ± 33.7; p < 0.05). The control group was younger than the therapeutic groups (p < 0.05). Compared with the control group, FMD was significantly higher only in the group treated with ACE inhibitors (3.42 ± 6.01 vs 0.82 ± 6.04; p < 0.05). Multivariate logistical regression showed that treatment with ACE inhibitors and statins (p < 0.05) were independent predictors of FMD > 4%. Conclusion. Treatment with ACE inhibitors or statins was predictive of the normalization of FMD in coronary patients in clinical practice.

1885-5857/© 2003 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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